Mental Health
Withdrawal and tolerance as related to compulsive sexual behavior disorder and problematic pornography use – Preregistered study based on a nationally representative sample in Poland.
Open Access: No.
Abstract
Background: The addiction model of compulsive sexual behavior disorder (CSBD) and problematic pornography use (PPU) predicts the presence of withdrawal symptoms and increased tolerance for sexual stimuli in the disorder phenotype. However, clear empirical evidence supporting this claim has largely been lacking.
Methods: In the preregistered, nationally representative survey (n = 1,541, 51.2% women, age: M = 42.99, SD = 14.38), we investigated the role of self-reported withdrawal symptoms and tolerance with respect to CSBD and PPU severity.
Results: Both withdrawal and tolerance were significantly associated with the severities of CSBD (β = 0.34; P < 0.001 and β = 0.38; P < 0.001, respectively) and PPU (β = 0.24; P < 0.001 and β = 0.27; P < 0.001, respectively). Of the 21 withdrawal symptom types investigated, the most often reported symptoms were frequent sexual thoughts that were difficult to stop (for participants with CSBD: 65.2% and with PPU: 43.3%), increased overall arousal (37.9%; 29.2%), difficult to control level of sexual desire (57.6%; 31.0%), irritability (37.9%; 25.4%), frequent mood changes (33.3%; 22.6%), and sleep problems (36.4%; 24.5%).
Conclusions: Changes related to mood and general arousal noted in the current study were similar to the cluster of symptoms in a withdrawal syndrome proposed for gambling disorder and internet gaming disorder in DSM-5. The study provides preliminary evidence on an understudied topic, and present findings can have significant implications for understanding the etiology and classification of CSBD and PPU. Simultaneously, drawing conclusions about clinical importance, diagnostic utility and detailed characteristics of withdrawal symptoms and tolerance as a part of CSBD and PPU, as well as other behavioral addictions, requires further research efforts.
Relevance
“The most frequently reported symptoms connected to withdrawal [from problematic pornography use] were more frequent sexual thoughts which were difficult to stop, increased overall arousal and difficult to control sexual desire.” Additionally: “Irritability, frequent mood changes, increased stress and sleep problems were also frequently reported. Such symptoms appear related to those reported for gambling disorder and internet gaming disorder.”
Those men with problematic pornography use also reported a “need for sexual activities to be more stimulating to reach the same level of arousal as in the past,” including the use of “more extreme” pornography.
The presence of both “tolerance” and “withdrawal symptoms” corroborates the utility of using an “addiction model” for problematic pornography use as a genuine “disorder.”
Citation
Lewczuk, K., Wizła, M., Glica, A., Potenza, M. N., Lew-Starowicz, M., & Kraus, S. W. (2022). Withdrawal and tolerance as related to compulsive sexual behavior disorder and problematic pornography use – Preregistered study based on a nationally representative sample in Poland. Journal of behavioral addictions, 11(4), 979–993. https://doi.org/10.1556/2006.2022.00076
